A total of 2,500 patients with an anamnesis of myocardial infarction at least 1 month prior to inclusion in the study who visited a general practitioner or an internal medicine or cardiology specialist were examined. Through an internet-based portal, physicians entered patient data, their complaints, treatment, blood pressure, heart rate and main biochemical parameters. There were more men (1 787 vs. 713) and patients under 70 years of age (1 491 vs. 1 009) in the cohort. Eighteen percent of patients had more than one MI. Mean age at the first infarction was 59.2 years in men and 64.9 in women (p < 0.001). NYHA breathlessness category higher than II was reported by 13.0% of patients only, 57.2% of patients reported they never had chest pain following an MI. Hypertension was the most frequent co-morbidity (84%). The mean blood pressure was 132/79 mmHg with no difference between men and women, the mean heart rate was 68/min, the mean cholesterol level was 4.55 mmol/l. 66% of patients had been prescribed all recommended pharmacotherapeutic groups according to guidelines (RAAS blockers, beta-blockers, statins, antiaggregation agents) and each group individually was used in > 90% of patients. There were no differences between men and women and older and younger patients. ACE inhibitors and statins were not always prescribed in recommended (high) doses. Ramipril and perindopril were the most frequently prescribed ACE inhibitors and atorvastatin the most frequently prescribed statin. There was a high level of compliance when it came to achieving the target blood pressure and heart rate values as well as to prescribing of the recommended drug groups. However, renin-angiotensin system-blocking agents and statins are not being prescribed in sufficiently high doses and this should be improved.

Interní kardiologická klinika Lékarské fakulty MU a FN Brno pracoviste Bohunice

Angiotensin-converting enzyme inhibitors, angiotensin-II-receptor antagonists and angiotensin-receptor blocker/neprilysin inhibitor utilization in heart failure patients: Sub-analysis of a nation-wide population-based study in the Czech Republic